Endoscopic suture systems are well-known in the art, having been described in U.S. Pat. Nos. 5,364,408; 5,458,609; 5,540,704; 5,575,800; 5,578,044; 5,713,910; 6,048,351; and 6,346,111 B1 to Gordon et al., and U.S. Pat. No. 6,096,051 to Kortenbach et al., all of which are incorporated herein by reference and referred to collectively herein as “the Gordon and Kurtenbach patents.” Commercial embodiments of these apparatus for placing sutures manufactured and sold by the assignee of the present invention are known in the art by the trademark CAPIO®. Other patents and commercial embodiments for endoscopic suturing are also known in the art.
Presently, these devices are capable of making a single stitch or “throw” inside the body, after which the device is retracted, and the suture is tied and cut, or the needle is reloaded in the device and the device returned to the body to place an additional stitch or “throw.”
Endoluminal devices comprise the general category of devices that may be implanted in a body lumen, including but not limited to endoluminal prostheses, such as stents, grafts, and combinations thereof commonly referred to as stent-grafts; vena cava filters; and the like. Endoluminal devices may be implanted by so-called “minimally invasive techniques” in which the device, restrained in a radially compressed configuration, is delivered by a deployment system or “introducer” to the site where it is required. The introducer may enter the body through the patient's skin, or by a “cut down” technique in which the entry lumen, such as a blood vessel, is exposed by minor surgical means. When the deployment system has been navigated into the body lumen to the device deployment location, the system is manipulated to cause the endoluminal device to be expanded to a predetermined diameter at the deployment location, and the deployment system is withdrawn. As referred to herein, “proximal” refers to the direction closer to the end of the delivery system outside of the body lumen, and “distal” refers to the direction opposite the “proximal” direction.
It would be particularly advantageous to be able to place a device endoluminally with sutures to hold it in place. Because it is desirable to have more than one suture to hold a device in place, such as to secure a cylindrical prothesis against the walls of a body lumen, endoluminal suturing devices proposed for use in a body lumen may benefit from the ability to throw more than one stitch without having to withdraw the suturing device from the body between stitches. Thus, it is desirable to provide a remotely-reloadable suturing device that can be employed in a body lumen. Remote reloading, however, is desirable for any type of endoscopic suturing, not just endoluminal suturing.